2879 (2) NO. STREET -
w APPLICATION' FORRBUIUDING PERMIT
° � �� ��UCITY OF CUPF.RTINO �ja�
° a Sanitary' Nu. 3-7 .
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5U (B 191961 t.
Dare_ 196_ PermNo.
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LL r Application is hereby made for a permit to
a m a/ T story,Type �, �' '' Building
o be occupied only as
o o in accordance.with Plans, Specificatiotrs agSl ,Ian fi_Igd herewith.
3 .Estimated Value of Improvements, V�d 00 VS,' Fee$ C��)
�n
z J It is hereby agreed that the requirennents,of the Cupertino Building and Zoning Ordinances and
* z all other laws applicable to)he construction, locatiop, and use of buildings witbm a of I,
0 Cuperon ill be pled 'th. Ste/ �/
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a °` Phon'e
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State License /s�o^ZZ22 BUILDING INSYF.c'0'
RECORD OF INSPEC'TIO'N APPROVALS;
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